APPLICATION FOR EMPLOYMENT

Transcription

1 City of Maupin PO Box 308 Tel: Deschutes Avenue Fax: Maupin, OR APPLICATION FOR EMPLOYMENT WE ARE AN EQUAL OPPORTUNTIY EMPLOYER We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status. Position Applied For: (PLEASE PRINT) Date of Application: Last Name First Name Middle Name Address Number Street City State Zip Code Mailing Address (if different than above) City State Zip Code Telephone Number(s) Home: Work: Message: Address Are you legally authorized to work in the United States? [ ] Yes [ ] No Have you ever worked for City of Maupin before? [ ] Yes [ ] No If Yes, what department? What date? On what date would you be available for work? Are you available to work: [ ] Full Time [ ] Part Time [ ] Temporary [ ] Weekends Can you travel if a job requires it? [ ] Yes [ ] No CITY OF MAUPIN APPLICATION FOR EMPLOYMENT 1 OF 6

2 EDUCATION TYPE NAME OF SCHOOL LOCATION CITY/STATE AREA OF CONCENTRATION (MAJOR) YEARS COMPLETED DID YOU GRADUATE? DIPLOMA, DEGREE OR CERTIFICATION RECEIVED HIGH SCHOOL COLLEGE OTHER EDUCATION OTHER EDUCATION SPECIAL SCHOOLING OR TRAINING / APPRENTICES COMPUTER PROGRAMS USED: COMPUTER PROFICIENCY: [ ] Low [ ] Medium [ ] High WITHIN YOUR FIELD, ARE YOU CURRENTLY: [ ] Registered [ ] Licensed [ ] Certified OR ELIGIBLE FOR: [ ] Registration [ ] Licensure [ ] Certification IF YES, TYPE? State or National Number Date Expires Indicate any foreign languages you can speak, read or write CITY OF MAUPIN APPLICATION FOR EMPLOYMENT 2 OF 6

3 EMPLOYMENT EXPERIENCE Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status. PRESENT AND FORMER EMPLOYERS DATES EMPLOYED POSITION AND DUTIES CITY OF MAUPIN APPLICATION FOR EMPLOYMENT 3 OF 6

4 If you need additional space, please continue on a separate sheet of paper. List professional, trade, business or civic activities and offices held. You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status: CITY OF MAUPIN APPLICATION FOR EMPLOYMENT 4 OF 6

5 ADDITIONAL INFORMATION Other Qualifications Summarize special job-related skills and qualifications acquired from employment or other experience. Include list of equipment operated. State any additional information you feel may be helpful to us in considering your application. REFERENCES Name Phone Name Phone Name Phone CITY OF MAUPIN APPLICATION FOR EMPLOYMENT 5 OF 6

6 APPLICANT S STATEMENT I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an at will nature, which means that the Employer may discharge or change the employment relationship, unilaterally, without cause with only limited exceptions which are imposed by law. Employee may resign at any time with or without reason or notice at any time. It is further understood that this at will employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. Signature of Applicant Date CITY OF MAUPIN APPLICATION FOR EMPLOYMENT 6 OF 6